Andrej Dukát, Milan Kriška
The link between LDL cholesterol levels and risk of severe cardiovascular events is nowadays well established in the evidence
based medicine as well as the place of statins, as the first line therapy among high risk cardiovascular patients.
The role of second line therapy for statins was proved in the study IMPROVE-IT adding ezetimibe, the most robust
hypolipidemic treatment study in the evidence based medicine. This study brought the evidence, that for LDL cholesterol
there exists the rule the lower, the better. With introducing a new group of hypolipidemic therapy with PCSK9 inhibition
into the clinical practice it is possible to obtain a significant decrease of LDL cholesterol levels. This is important
for the secondary prevention mainly for the patients with familial hypercholesterolemia or for those with statin intolerance,
where it is not possible to use the high doses of statins.